加固缝合吻合口在腹腔镜结直肠癌根治术中的应用价值  

Application value of reinforced suture anastomosis in laparoscopic radical resection of colorectal cancer

作　　者：邹俊伟 吴兆映 左思源 黄勇 ZOU Junwei;WU Zhaoying;ZUO Siyuan;HUANG Yong(Department of Gastrointestinal Surgery,the Second Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)

机构地区：[1]皖南医学院第二附属医院胃肠外科,安徽芜湖241001

出　　处：《中国肿瘤外科杂志》2024年第4期357-360,共4页Chinese Journal of Surgical Oncology

基　　金：2023年安徽省高等学校自然科学研究重点项目(2023AH051777);2023年芜湖市卫生健康委重点项目(WHWJ2023z007)。

摘　　要：目的分析加固缝合吻合口在腹腔镜结直肠癌根治术中的应用价值。方法选取2022年2月至2023年11月皖南医学院第二附属医院收治的70例行腹腔镜结直肠癌根治术患者为研究对象。根据是否采用改良技术分为两组,加固吻合组在肠管吻合后,两次闭合器切割线形成的交叉区行加固缝合,并加固吻合口前壁,对照组采用传统缝合,各35例。对比两组患者围术期相关指标、术后炎症反应情况C反应蛋白(CRP)、降钙素原(PCT)、白介素⁃6(IL⁃6)、全身免疫炎症指数(SII)及胃肠功能胃动素(MTL)、胃泌素(GAS)、二胺氧化酶(DAO),并记录术后并发症发生情况。结果加固缝合组患术后住院时间短于对照组(P<0.05)。加固缝合组患者CRP、PCT、IL⁃6及SII均低于对照组(P<0.05)。加固缝合组患者MTL及GAS均高于对照组,DAO低于对照组(P<0.05)。加固缝合组患者术后并发症总发生率(5.72%)低于对照组(22.87%)(P<0.05)。结论加固缝合吻合口可帮助降低腹腔镜结直肠癌根治术后炎症反应程度,缩短患者住院时间,且并不增加术后并发症发生风险,安全可行。Objective To analyze the application value of reinforced suture anastomosis in laparoscopic radical surgery for colorectal cancer.Methods Seventy cases of laparoscopic radical resection of colorectal cancer patients admitted to the Second Affiliated Hospital of Wannan Medical College from February 2022 to November 2023 were selected as the study subjects.According to whether advanced techniques were adopted,the patients were divided into two groups:the reinforcement anastomosis group underwent reinforcement suturing at the intersection formed by the two stapler incisions after intestinal anastomosis and reinforcement of the anterior wall of the anastomosis;the control group adopted traditional suturing.There were 35 cases in each group.Perioperative relevant indexes,postoperative inflammatory response C⁃reactive protein(CRP),procalcitonin(PCT),interleukin⁃6(IL⁃6),systemic immunoinflammatory index(SII)and gastrointestinal function(MTL),gastrin(GAS),diamine oxidase(DAO)of the two groups were compared,and postoperative complications were recorded.Results The hospital stay of the reinforced suturing group was shorter than that of the control group(P<0.05).The CRP,PCT,IL⁃6 and SII in the reinforced suturing group were lower than those in the control group(P<0.05).MTL and GAS in the reinforced suturing group were higher than those in the control group,and DAO was lower than that in the control group(P<0.05).The total incidence of postoperative complications in the reinforced suturing group(5.72%)was lower than that in the control group(22.87%)(P<0.05).Conclusions The reinforcement suturing of anastomosis can help reduce the degree of inflammatory reaction after laparoscopic radical surgery for colorectal cancer,shorten the patient's hospital stay,and does not increase the risk of postoperative complications,which is safe and feasible.

关 键 词：加固缝合吻合口 腹腔镜 结直肠癌根治术 

分 类 号：R735.34[医药卫生—肿瘤]